{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T14:09:13Z","timestamp":1740146953927,"version":"3.37.3"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T00:00:00Z","timestamp":1733702400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Australian Commonwealth Government Research Training Program Scholarship"},{"DOI":"10.13039\/100014607","name":"Royal Children's Hospital Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014607","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>In children with cancer, febrile neutropenia (FN) is one of the most common complications of treatment, a leading cause of unplanned and prolonged hospital admission and is the key driver of antibiotic exposure. Co-designed with key stakeholders, \u2018Early versus Late Stopping of Antibiotics in high-risk FN\u2019 (<jats:italic>ELSA-FN<\/jats:italic>) is a randomised controlled, non-inferiority trial that compares stopping antibiotics in clinically stable patients after 48 hours with the current standard of care, continuing antibiotics until absolute neutrophil recovery. As an Australian first, we will exploit the potential of electronic medical record (EMR) systems, embedding all key aspects of the trial including screening, consent, randomisation and data collection into standard clinical and EMR workflows. We aim to randomise 320 children with high-risk FN and prospectively collect data on safety, acceptability to clinicians and families, as well as several secondary outcomes related to antibiotic exposure. The findings will contribute to optimal antibiotic use in children with FN internationally and inform design and implementation of future EMR-embedded trials.<\/jats:p>","DOI":"10.1371\/journal.pone.0311523","type":"journal-article","created":{"date-parts":[[2024,12,9]],"date-time":"2024-12-09T18:23:39Z","timestamp":1733768619000},"page":"e0311523","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Protocol for an embedded randomised controlled trial of Early versus Late Stopping of Antibiotics in children with Febrile Neutropenia (ELSA-FN)"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6499-337X","authenticated-orcid":true,"given":"Coen","family":"Butters","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anneke","family":"Grobler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4282-9648","authenticated-orcid":true,"given":"Alannah","family":"Rudkin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li-yin","family":"Goh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Werdenburg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diane","family":"Hanna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Theresa","family":"Cole","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jim","family":"Buttery","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin","family":"Thursky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Davidson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabrielle M.","family":"Haeusler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2024,12,9]]},"reference":[{"key":"pone.0311523.ref001","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1038\/bjc.2017.154","article-title":"Predicting Infectious ComplicatioNs in Children with Cancer: an external validation study","volume":"117","author":"GM Haeusler","year":"2017","journal-title":"Br J Cancer"},{"key":"pone.0311523.ref002","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/S2352-4642(22)00095-5","article-title":"Worldwide trends in population-based survival for children, adolescents, and young adults diagnosed with leukaemia, by subtype, during 2000\u201314 (CONCORD-3): analysis of individual data from 258 cancer registries in 61 countries","volume":"6","author":"N Ssenyonga","year":"2022","journal-title":"Lancet Child Adolesc Health"},{"key":"pone.0311523.ref003","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1086\/522533","article-title":"A prospective study on the epidemiology of febrile episodes during chemotherapy-induced neutropenia in children with cancer or after hemopoietic stem cell transplantation","volume":"45","author":"E Castagnola","year":"2007","journal-title":"Clin Infect Dis"},{"key":"pone.0311523.ref004","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1046\/j.1365-2141.1997.4453255.x","article-title":"A comparison of outcome from febrile neutropenic episodes in children compared with adults: results from four EORTC studies. 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